Effectiveness of Nursing Interventions on Preoperative Anxiety and Postoperative Outcomes Among Patients Undergoing Orthopaedic Surgery: A Systematic Review and Meta-Analysis.

BACKGROUND

Preoperative anxiety and postoperative complications significantly impact recovery among orthopaedic surgery patients. Nursing interventions, including education, psychological support and physical care, have shown potential in improving surgical outcomes. This review evaluated the effectiveness of nursing interventions in reducing anxiety, pain and postoperative complications among patients undergoing orthopaedic surgeries.

METHODS

A comprehensive search was conducted across PubMed, CINAHL, EMBASE, Cochrane Library and Scopus, resulting in the inclusion of 59 studies. Outcomes assessed were preoperative anxiety (eight studies), postoperative anxiety (nine studies), pain (16 studies), surgical site infections (36 studies), poor incision healing (three studies) and deep vein thrombosis (two studies). Standardized mean differences (SMD) and odds ratios (OR) were pooled using random-effects models. Heterogeneity was assessed using I2 and tau2, and sensitivity analyses were performed.

RESULTS

Nursing interventions showed no significant effect on preoperative anxiety (SMD -0.301; p = 0.082), postoperative anxiety (SMD -0.408; p = 0.137) or postoperative pain (SMD -0.203; p = 0.325). However, significant reductions were observed for surgical site infections (OR 1.122; p < 0.001), poor incision healing (OR 0.381; p = 0.012) and DVT (OR 0.132; p = 0.020). Heterogeneity was high for anxiety and pain outcomes but minimal for infections and healing. Sensitivity analyses confirmed the robustness of results.

CONCLUSION

Nursing interventions significantly reduce surgical site infections, poor incision healing and DVT, underscoring their role in perioperative care. However, their impact on anxiety and pain remains inconclusive, warranting further research. Standardized intervention protocols and targeted studies are needed to optimize nursing care in orthopaedic surgery.